Ecchymosis

Ecchymosis Definition

Ecchymosis is a kind of skin condition and should not be confused with bruises. The term is described as hemorrhagic blotching that happens just beneath the thin layer of the skin wherein a pool of blood accumulates due to rupture of blood vessels and causes discoloration of the skin. Unlike bruises, Ecchymosis is larger in size, usually more than 1 centimeter and is caused due to trauma, such as Marburg virus diseases or pathophysiologic cell function.

How is Ecchymosis different from a bruise, purpura, hemorrhage, and hematoma?

A bruise happens if the damage is caused to the blood vessels under the upper layer of the skin. Due to forceful impact, the vessels burst open and blood leaks out that forms like a pool under the skin. Platelets in the blood help in the blood clotting process that gives a blackish, bluish or purplish tint to the skin. Ecchymosis, on the other hand, is not necessarily caused by any external injury and looks almost like spots of purpura with sizes larger than 1 cm.

Purpura appears same as Ecchymosis in a reddish and purplish color, but Purpura is smaller in size that does not blanch and measures between 3-10 mm (approx.). Unlike Ecchymosis spots, purpura comes with more distinct borders. The mark is impacted on your skin by external pressure.

Hemorrhage is defined as the burst out of blood vessels and leakage of blood underneath the skin layer causing discoloration of your skin. Hematoma, on the other hand, is described as accumulation or clotting of blood that may appear on the tissues, organs or on body space due to breakage of blood vessel walls.

Ecchymosis Types

Do know this that Ecchymosis, which is an under-skin bleeding may attack various body parts. Several internal factors are responsible for this type of skin condition that has been classified on the basis of areas as follows:

Mastoid Region

Also known as Mastoid Ecchymosis, it is defined as the bruising caused due to mastoid process because of fracture to the base of the skull. This type of Ecchymosis is associated with any underlying brain trauma.

Eyes

Referred to as periorbital ecchymosis or Raccoon eyes, this type of skin condition occurs due to blunt injury or contusion to the base skull or frontal skull. Even an eye injury may lead to this type of medical condition that shows signs of tenderness and swelling.

Inguinal Pubic area

Reasons like a ruptured abdominal aneurysm or ectopic pregnancy cause inguinal ecchymosis (Stabler’s sign) and scrotal ecchymosis (Bryant’s sign).

Umbilical Region

The condition of ecchymosis attacks and causes bruising to the fatty tissues located around the umbilicus. Other reasons like a ruptured cyst and liver cirrhosis also cause bruising in the same area.

Lower Abdomen

Under this condition, bruising is caused across the chest, abdomen and on the neck. It happens usually due to a motor vehicle accident.

Lateral Abdominal wall

This is also referred to by the name of Grey Turner’s sign that causes bruising between the top of the hip and last rib area. The reasons that may lead to the condition include bilateral salpingitis, intrauterine pregnancy, abdominal aneurysm and rupture of the spleen.

Ecchymosis Symptoms

The symptoms associated with the ecchymosis are:

• Unexplained bruising
• Bruises (contusions)
• Internal bleeding
• Hematoma
• Under-skin bleeding
• Hemorrhagic rash
• Petechiae
• Capillary Haemorrhage

There are other skin symptoms that should also be taken into consideration:

• Angioma
• Rash
• Skin redness
• Hives
• Hemangioma
• Hyperpigmentation
• Skin darkening
• Boils
• Blisters
• Pustular rash

More Symptoms:

• Discoloration of your skin, turning into purple and red color
• Pain on the body on the affected area. However, pain does not show in all patients.
• Large patches that have diameters of minimum one inch and more for each.
• Inflammation of the skin surrounding the area where the skin is affected. The severity of the inflammation or discoloration of your skin depends upon the extent of tissue damage.

Ecchymosis Causes

At the first glance, ecchymosis may look like a blood spot that is caused due to a fight or punch. However, various health conditions and internal diseases result into ecchymosis. Let’s have a look at the various factors that usually cause bleeding under the skin:

• Leukemia
• Allergic reaction
• Septicemia
• Bruise birth
• Multiple myelomas
• Anticoagulants like steroids, heparin, aspirin
• Aging skin
• Henoch-Schonlein purpura
• Viral infections, or diseases influencing blood clotting
• Chemotherapy, radiation therapy
• Blood thinners like warfarin or aspirin
• Dietary supplements

Let’s have a discussion of the above few causes and how do they induce ecchymosis:

Myelofibrosis

It is a type of fibrosis formation that occurs in the bone marrow tissues. When fibrosis develops in the tissues, it deters the normal production of the blood cells. This results in ecchymosis.

Multiple Myeloma

This is a type of cancer wherein the plasma white blood cells show abnormal growth in the bone marrow. This uncontrolled and abnormal growth of cells provokes ecchymosis that appears like bruising on the human skin.

Ecchymosis in children

It is common in children since the little ones get patchy skins due to skin injury while playing or from falling down. Also, black eyes are common that a child may get from his peers. However, the condition is also commonly seen in neonates that are caused owing to a deficiency in Vitamin C or due to low platelet count.

Acute renal failure

The function of the kidney is to extract waste from the body, but in the process waste products may percolate into the bloodstream due to certain abnormalities in the kidney functions. Ecchymosis is caused when these waste substances get into the blood due to degeneration of your kidney.

Bulimia

Bulimia is a condition caused by self-induced vomiting. It is done by putting the hand in the mouth that causes gag reflex to provoke vomiting. It happens because the hand when putting inside the mouth gets rubbed with the teeth, which results in crusted papules at the back of your hand. Signs of ecchymosis appear on the fist and fingertips due to clenching of the fist. In a few days, signs of bleeding are visible below the nails.

Vitamin D deficiency

Deficiency of Vitamin D causes ecchymosis, purpura, and hemorrhage. The probable reasons are clotting factors X, IX, VII and II. The therapy for this issue includes injection of vitamin K 5-10 mg daily for the suggested number of days by the doctor.

Liver Cirrhosis

Liver cirrhosis or liver impairment may lead to alteration in your blood composition that may result into ecchymosis.

Ecchymosis Diagnosis

Doctors can easily diagnose ecchymosis by close observation of the affected area. If in case the injury looks serious, your doctor may recommend for an X-ray to find out if there are any broken bones. If the actual reason for bruises is not properly detected, the doctor may want a blood test to understand the platelet count in blood. A coagulation test may also be performed to check how the blood clots and how long it is taking to clot.

Ecchymosis Treatment

The treatment of ecchymosis depends upon the underlying conditions. In mild cases, no such treatment is required as the affected area gets healed by its own. However, if there is a consistent manifestation of skin discoloration and associated pain, the same should be referred to a doctor. The type of medicines usually prescribed by the doctor depends upon the diagnosed condition:

• Desmopressin acetate– It is prescribed for treating mild platelet dysfunctions, for instance, Type 1 von Willebrand disease.
• Doxycycline antibiotic– It helps to treat infections caused by ecchymosis.
• Prednisone– It may be prescribed solely or in combination with other drugs used for chemotherapy, such as vincristine for the treatment of immune-type thrombocytopenia.

Before suggesting any particular treatment, the doctor first tries to study the underlying reason for the disease. Some other treatment options that are quite common:

• Using ice- Patients are suggested to apply ice at home on the affected areas in order to enable vasoconstriction of the damaged blood vessels. This helps in preventing further spread of the blood to the nearby body areas.
• Painkillers- Patients may complain of pain from ecchymosis that is best treated with painkillers like acetaminophen or any other type of analgesics.
• Rest- It is most important to rest during this time as fewer body movements induce quicker healing of the broken blood tissues.
• Light massage and exercise- Both ensure healing effects of ecchymosis and tissue repairs. However, make sure that the body pressure used during massages should be soft and mild since too much pressure can aggravate the condition of the damaged blood vessels.
• Platelet transfusion or blood transfusion is required for the treatment of this type of skin condition.
• Any such drugs that may increase platelet function should be stopped immediately like aspirin or NSAIDs drugs.
• The right intake of fluid volume is necessary with the right balance of an electrolyte solution.

What type of diet should you follow?

• Foods high with folate– Folic acid is good for patients suffering from ecchymosis since it ensures a quicker recovery. Folate has many characteristics, such as it aids in the quicker healing of bruises, tissue regeneration, and cell reproduction. The daily dose of folate intake is 400 grams for children and 400 grams for adults. The foods that are rich in folate are nuts, fruits, legumes and fortified foods.
• Foods rich in vitamin C- Vitamin C is not produced naturally in the body, therefore you should have foods that are rich in it. Vitamin C has the properties to enable quick tissue regeneration. Besides, it has skin regenerative and anti-oxidant properties. The recommended dosage for men is 90 mg daily and for women is 75 mg daily.
• Vitamin K rich food– Deficiency of vitamin K in blood prevents blood clotting ability after you have a bruise or cut. Therefore, make sure that you have sufficient Vitamin K supplements that not just help in blood clotting, but also treat symptoms of your ecchymosis.
• Foods rich in Vitamin B-12– Following a diet rich in vitamin B12 enables in quicker healing of bruises. The properties of Vitamin B-12 function by promoting platelet count. It is often seen that deficiency of vitamin B-12 is mostly found in pregnant women and in the elderly. The right dose of vitamin B-12 is 2.4 mg daily. Foods that should be taken include fish, fortified cereal, chicken, eggs and low-fat milk.

Ecchymosis Pictures

Frequently Asked Questions

Which body areas does ecchymosis affect?

It can affect any body area. However, if symptoms of bruises or discoloration of skin appear without any type of external injury, it should be referred to the doctor right away.

Which doctor is best for treating ecchymosis?

First, check out with a general physician. If the condition is complicated then you may refer to a specialist.

What type of medicines should not be taken during Ecchymosis?

Anticoagulants such as Aspirin and NSAID such as Ibuprofen.

Is ecchymosis a threat to life?

Although Ecchymosis is not so life-threatening, it can be fatal if it attacks the periorbital area like the base of the skull due to fracture. This type of medical condition needs urgent doctor’s attention.

What are the different procedures of cure of ecchymosis?

The skin condition can be cured at home with the right prescribed medications and foods. However, a physician should be referred to in case of deeper sutures or if there is any underlying cause involved.